Utah Cap Haps Blog

Friday, October 30, 2015

Medicaid Expansion in a Nutshell


One of the unintended consequences of the Affordable Care Act (Obamacare) was that it created a coverage gap for people in the State of Utah who make too much money to qualify for Medicaid coverage and not enough money to qualify for tax subsidies to purchase private insurance coverage. 

During the last legislative session, the legislature could not agree on any of the proposed plans to resolve this issue. As a result, the legislature passed a resolution forming a small group that would continue working on a revised proposal. This group was later labeled,  the "Gang of Six" (Governor, Lt. Governor, Senate President, House Speaker, Majority Leader and the primary sponsor of the original proposal). 

The Gang of Six came up with a plan called, Access Plus.


The Health Reform Taskforce met on October 6th to review the Utah Access+ plan and associated waiver requests. The committee met for four hours, about an hour longer than scheduled, in order to listen to the constituents and stakeholders who wanted to be heard. Listen to the meeting through this link. You may also view a list of public comments that was provided in writing. 

The plan implemented a cost share in the financing of the plan, where the state would pay one third of the state's share, and the medical providers would pay two thirds. For details, see the actual Utah Access+ Medicaid Expansion Proposal.

The House Majority Caucus largely disapproved of the new proposal, with fewer supporters than for Healthy Utah. Watch the press interview right after the meeting, along with a brief Utah Policy interview that provides a summary of the issues surrounding the new proposal.

The plan failed to garner sufficient support in either the Senate or the House of Representatives. One of the primary arguments to support expansion was that we are paying federal taxes to the federal government and getting nothing in return. With the release of new budget estimates, we recently learned from our Legislative Fiscal Analyst that without expansion, we are getting back even more than we paid out. Below are the recently released numbers.

As mentioned repeatedly by legislative leadership in both the House and Senate, this issue is not likely to go away. Additional forthcoming proposals are anticipated.